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  • 1.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark; Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Preminger, Jill E.
    University of Louisville, KY 40292 USA.
    Internet and Audiology: A Review of the First International Meeting2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, 269-270 p.Article, review/survey (Refereed)
    Abstract [en]

    Purpose: The purpose of this research forum article is to describe the impetus for holding the First International Meeting on Internet and Audiology (October 2014) and to introduce the special research forum that arose from the meeting. Method: The rationale for the First International Meeting on Internet and Audiology is described. This is followed by a short description of the research sections and articles appearing in the special issue. Six articles consider the process of health care delivery over the Internet; this includes health care specific to hearing, tinnitus, and balance. Four articles discuss the development of effective Internet-based treatment programs. Six articles describe and evaluate Internet-based interventions specific to adult hearing aid users. Conclusion: The fledgling field of Internet and audiology is remarkably broad. The Second International Meeting on Internet and Audiology ocurred in September 2015.

  • 2.
    Brännström, Jonas K
    et al.
    Linköping University, Faculty of Arts and Sciences. Dept of clinical science, Section of Logopedics, Phoiatrics and audiology, Lund University, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N. T.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Denmark.
    The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, 320-324 p.Article in journal (Refereed)
    Abstract [en]

    Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. Conclusion: An Internet-based support system was successfully developed for audiologic practice.

  • 3.
    Brännström, Jonas
    et al.
    Clinical Sciences Lund, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N T
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Department of Clinical Neuroscience, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    The initial evaluation of an internet-based support system for audiologists and first-time hearing aid clientsThe process of developing an internet-based support system for audiologists and first-time hearing aid clients2016In: Internet Interventions, ISSN 2214-7829, Vol. 4, no 1, 82-91 p.Article in journal (Refereed)
  • 4.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Carlton, Australia.
    Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids2014In: International Journal of Audiology, ISSN 1499-2027, Vol. 53, no S1, S68-S75 p.Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centred care is a term frequently associated with quality health care. Despite extensive literature from a range of health-care professions that provide description and measurement of patient-centred care, a definition of patient-centredness in audiological rehabilitation is lacking. The current study aimed to define patient-centred care specific to audiological rehabilitation from the perspective of older adults who have owned hearing aids for at least one year. Design: Research interviews were conducted with a purposive sample of older adults concerning their perceptions of patient-centredness in audiological rehabilitation, and qualitative content analysis was undertaken. Study sample: The participant sample included ten adults over the age of 60 years who had owned hearing aids for at least one year. Results: Data analysis revealed three dimensions to patient-centred audiological rehabilitation: the therapeutic relationship, the players (audiologist and patient), and clinical processes. Individualised care was seen as an overarching theme linking each of these dimensions. Conclusions: This study reported two models: the first model describes what older adults with hearing aids believe constitutes patient-centred audiological rehabilitation. The second provides a guide to operationalised patient-centred care. Further research is required to address questions pertaining to the presence, nature, and impact of patient-centred audiological rehabilitation.

  • 5.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Patient-centred care: A review for rehabilitative audiologists2014In: International Journal of Audiology, ISSN 1499-2027, Vol. 53, no S1, S60-S67 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  • 6.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Center, Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Communication Patterns in Audiologic Rehabilitation History-Taking: Audiologists, Patients, and Their Companions2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 2, 191-204 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Design: Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. Results: The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the remainder of the history, audiologists asked 97% of the questions and did so primarily in closed-ended form. This resulted in the audiologist talking as much as the patient and much more than the companions when they were present. Questions asked by the audiologist were balanced in topic: biomedical and psychosocial/lifestyle; however, few emotionally focused utterances were observed from any speaker (less than 5% of utter ances). Conclusions: Analysis of verbal communication involving audiologists, patients, and companions in the history-taking phase in 63 initial audiology consultations revealed a communicative exchange that was audiologist-controlled and structured, but covered both medical and lifestyle content. Audiologists often attempted to create a relationship with their patients; however, little emotional relationship building occurred, which may have implications later in the consultation when management decisions are being made. These results are not in line with patient-centered communication principles. Further research and changes to clinical practice are warranted to transform patient-centered communication from an ideal to a reality.

  • 7.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidsont, Bronwyn
    University of Melbourne, Australia.
    The Nature of Communication throughout Diagnosis and Management Planning in Initial Audiologic Rehabilitation Consultations2015In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 26, no 1, 36-50 p.Article in journal (Refereed)
    Abstract [en]

    Background: Effective practitioner-patient communication throughout diagnosis and management planning positively influences patient outcomes. A patient-centered approach whereby patient involvement in decision making is facilitated, a therapeutic relationship is developed, and information is bilaterally exchanged in an appropriate manner, leads to improved patient satisfaction, adherence to treatment, and self-management. Despite this knowledge, little is known about the nature of audiologist-patient communication throughout diagnosis and management planning. Purpose: This research aimed to explore verbal communication between audiologists and patients/ companions throughout diagnosis and management planning in initial audiology consultations. Specifically, this study aimed to describe the nature and dynamics of communication by examining the number, proportion, and type of verbal utterances by all speakers (audiologist, patient, and companion when present). In addition, this study aimed to investigate the influence of audiologist, patient, and consultation factors, such as verbal dominance, content balance, and communication control, on the dynamics of communication. Study Sample: A total of 62 initial audiological rehabilitation consultations (involving 26 different audiologists) were filmed and analyzed using the Roter Interaction Analysis System. All patients were older than 55 yr, and a companion was present in 17 consultations. Data Collection and Analysis: This study focused solely on the communication relating to diagnosis and management planning (referred to as the "counseling phase"). Diagnosis, recommendations, rehabilitation options, and patient decisions were recorded along with the communication profiles and communication dynamics measured using the Rotor Interaction Analysis System. Associations between communication dynamics (content balance, communication control, and verbal dominance) and eight variables were evaluated with Linear Mixed Model methods. Results: The mean length of time for diagnosis and management planning was 29.0 min (range, 2.2- 78.5 min). Communication profiles revealed that patient-centered communication was infrequently observed. First, opportunities to build a relationship were missed, such that patients psychosocial concerns were rarely addressed and patients/companions showed little involvement in management planning. Second, the amount of talk was asymmetrical and the majority of audiologists education and counseling utterances related to hearing aids; yet, only 56% of patients decided to obtain hearing aids at the conclusion of the consultation. Hearing aids were recommended in 83% of consultations where a hearing loss was diagnosed and alternative options were rarely provided. Thus, shared decision making rarely occurred, and audiologists often diagnosed a hearing loss and recommended hearing aids without patient involvement. In addition, when a greater proportion of time was dedicated to diagnosis and management planning, patients had greater input and control by asking more questions and requesting further information. Conclusions: Patient-centered communication was rarely observed in the 62 consultations. Thus, although not measured in this study, patient outcomes are likely to be affected. Future research should examine the influence of audiologist communication on outcomes and encourage a shift toward patient-centered audiological rehabilitation.

  • 8.
    Hickson, Louise
    et al.
    University of Queensland, Brisbane, Australia.
    Laplante-Lévesque, Ariane
    University of Queensland, Brisbane, Australia.
    Wong, Lena
    University of Hong Kong, Pokfulam.
    Evidence-based practice in audiology: rehabilitation options for adults with hearing impairment2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, 329-331 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Three questions are addressed: 1) What is Evidence-Based Practice (EBP) and why is it important for adults with hearing impairment? 2) What is the evidence about intervention options for adults who fail a hearing screening and are identified with hearing impairment? 3) What intervention options do adults choose when identified with hearing impairment for the first time?

    METHODS:

    The five steps of the EBP process are discussed in relation to a clinical question about whether hearing aids and communication programs reduce activity limitations and participation restrictions compared to no treatment for adults who fail a hearing screening and are identified with hearing impairment.

    RESULTS:

    Systematic reviews of the evidence indicate that both hearing aids and communication programs reduce activity limitations and participation restrictions for this population and are therefore appropriate options. A study is then described in which these options were presented to 153 clients identified with hearing impairment for the first time: 43% chose hearing aids, 18% chose communication programs and the remaining 39% chose not to take any action.

    CONCLUSIONS:

    EBP supports the offer of intervention options to adults who fail a hearing screening and are identified with hearing impairment.

  • 9.
    Ingo, Elisabeth
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Brännström, K Jonas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Clinical Neuroscience, Karolinska Institute, Sweden; Eriksholm Research Centre, Oticon a/S, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon a/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon a/S, Denmark.
    Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no Suppl 3, S52-S58 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.

    DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.

    STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.

    RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.

    CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

  • 10.
    Ingo, Elisabeth
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Brännström, K. Jonas
    Department of logopedics, phoniatrics and audiology, Lund University, Sweden and Institutet för handikappvetenskap (IHV), The Swedish Institute for Disability Research.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Stages of change in audiology: comparison of three self-assessment measures2017In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 7, 516-520 p.Article in journal (Refereed)
    Abstract [en]

    Objective: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a persons journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Design: Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. Study sample: In total, 224 adults completed the three measures. Results: A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

  • 11.
    Knudsen, Line V
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Laplante-Levesque, Ariane
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Jones, Lesley
    University of York, UK.
    Preminger, Jill E
    University of Louisville, USA.
    Nielsen, Claus
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Naylor, Graham
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Kramer, Sophia E
    VU University Medical Center, EMGO+ Institute, Amsterdam, The Netherlands.
    Conducting qualitative research in audiology: A tutorial2012In: International Journal of Audiology, ISSN 1499-2027, Vol. 51, no 2, 83-92 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    Qualitative research methodologies are being used more frequently in audiology as it allows for a better understanding of the perspectives of people with hearing impairment. This article describes why and how international interdisciplinary qualitative research can be conducted.

    DESIGN:

    This paper is based on a literature review and our recent experience with the conduction of an international interdisciplinary qualitative study in audiology.

    RESULTS:

    We describe some available qualitative methods for sampling, data collection, and analysis and we discuss the rationale for choosing particular methods. The focus is on four approaches which have all previously been applied to audiologic research: grounded theory, interpretative phenomenological analysis, conversational analysis, and qualitative content analysis.

    CONCLUSIONS:

    This article provides a review of methodological issues useful for those designing qualitative research projects in audiology or needing assistance in the interpretation of qualitative literature.

  • 12.
    Knudsen, Line V.
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Nielsen, Claus
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Kramer, Sophia E.
    VU University Medical Center, EMGO+ Institute, Amsterdam, The Netherlands.
    Jones, Lesley
    University of York, UK.
    Laplante-Lévesque, Ariane
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Client labor: adults with hearing impairment describing their participation in their hearing help-seeking and rehabilitation2013In: Journal of the American Academy of Audiology, ISSN 1050-0545, Vol. 24, no 3, 192-204 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The uptake and use of hearing aids is low compared to the prevalence of hearing impairment. People who seek help and take part in a hearing aid rehabilitation process participate actively in this process in several ways.

    PURPOSE:

    In order to gain more knowledge on the challenges of hearing help-seeking and hearing aid use, this qualitative study sought to understand the ways that people with hearing impairment describe themselves as active participants throughout the hearing aid rehabilitation process.

    RESEARCH DESIGN:

    In this qualitative interview study we examined the hearing rehabilitation process from the perspective of the hearing impaired. In this article we describe how the qualitative interview material was interpreted by a pragmatic qualitative thematic analysis. The analysis described in this article focused on the efforts, initiatives, actions, and participation the study participants described that they had engaged in during their rehabilitation.

    STUDY SAMPLE:

    Interviews were conducted with people with hearing impairment in Australia, Denmark, the United Kingdom, and the United States. The 34 interview participants were distributed equally between the sites, just as men and women were almost equally represented (56% women). The average age of the participants was 64. All participants had a hearing impairment in at least one ear. The participants were recruited to represent a range of experiences with hearing help-seeking and rehabilitation.

    DATA COLLECTION AND ANALYSIS:

    With each participant one qualitative semistructured interview ranging between 1 and 2 hr was carried out. The interviews were transcribed verbatim, read through several times, and themes were identified, defined, and reviewed by an iterative process.

    RESULTS:

    From this thematic focus a concept called "client labor" has emerged. Client labor contains nine subthemes divided into three overarching groups: cognitive labor, emotional labor, and physical labor. The participants' experiences and meaning-making related to these conceptual types of efforts is described.

    CONCLUSIONS:

    The study findings have implications for the clinical encounter between people with hearing impairment and hearing health-care professionals. We suggest that a patient-centered approach that bears in mind the client's active participation could help toward improving clinical dispensing, fitting, and counseling practices with the end goal to increase hearing aid benefit and satisfaction

  • 13.
    Laplante-Levesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Denmark.
    Brännström, Jonas
    Lund University, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Denmark.
    Stages of change in adults who failed an online hearing screening2013Conference paper (Other academic)
  • 14.
    Laplante-Levesque, Ariane
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Knudsen, Line V
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Preminger, Jill E
    University of Louisville, USA.
    Jones, Lesley
    University of York, UK.
    Nielsen, Claus
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Naylor, Graham
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Kramer, Sophia E
    VU University Medical Center, EMGO+ Institute, Amsterdam, The Netherlands.
    Hearing help-seeking and rehabilitation: Perspectives of adults with hearing impairment2012In: International Journal of Audiology, ISSN 1499-2027, Vol. 51, no 2, 93-102 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation.

    DESIGN:

    Individual semi-structured interviews were completed.

    STUDY SAMPLE:

    In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users.

    RESULTS:

    Qualitative content analysis identified four main categories ('perceiving my hearing impairment', 'seeking hearing help', 'using my hearing aids', and 'perspectives and knowledge') and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed.

    CONCLUSIONS:

    People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed.

  • 15.
    Laplante-Levesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Octicon A/S, Research Centre Eriksholm, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon A7S, Reserach Centre Eriksholm, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Adults with hearing impairment and their significant others searching for hearing impairment information on the Internet: Qualily and readability of English-language websites2011Conference paper (Other academic)
    Abstract [en]

    People with health conditions and their significant others are increasingly turning to the Internet for health information. Accessing health information is, after email and search engine use, the third most common Internet activity (Pew Internet. 2011 ). For people facing a health decision, Internet is the second most influential source of information after clinician advice (Couper et al., 2010). Searching the Internet for a significant other’s health condition is also common (Pew Internet, 2011 ). However, clients do not always methodically analyse the quality of health information accessed on the Internet. For this reason, quality of Internet health information has been widely studied and has been found to vary greatly (for a systematic review, see Eysenbach, Powell, Kuss, & Sa, 2002). In audiology, it is largely unknown whether adults with hearing impairment and their significant others are informed or misinformed by the hearing impairment information they access on the Internet. This study aims to evaluate the Internet hearing information available to people with hearing impairment and their significant others. More specifically, the study is assessing the quality and readability of English-language websites available as of 2011. This study’s methods and emerging results are presented and discussed.

  • 16.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Abrams, Harvey
    Starkey Hearing Technology Inc, MN USA.
    Bulow, Maja
    Widex AS, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Nelson, John
    GN ReSound, IL USA.
    Kamaric Riis, Soren
    Oticon Medical AS, Denmark.
    Vanpoucke, Filiep
    Cochlear Technology Centre, Belgium.
    Hearing Device Manufacturers Call for Interoperability and Standardization of Internet and Audiology2016In: AMERICAN JOURNAL OF AUDIOLOGY, ISSN 1059-0889, Vol. 25, no 3, 260-263 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: This article describes the perspectives of hearing device manufacturers regarding the exciting developments that the Internet makes possible. Specifically, it proposes to join forces toward interoperability and standardization of Internet and audiology. Method: A summary of why such a collaborative effort is required is provided from historical and scientific perspectives. A roadmap toward interoperability and standardization is proposed. Results: Information and communication technologies improve the flow of health care data and pave the way to better health care. However, hearing-related products, features, and services are notoriously heterogeneous and incompatible with other health care systems (no interoperability). Standardization is the process of developing and implementing technical standards (e.g., Noah hearing database). All parties involved in interoperability and standardization realize mutual gains by making mutually consistent decisions. De jure (officially endorsed) standards can be developed in collaboration with large national health care systems as well as spokespeople for hearing care professionals and hearing device users. The roadmap covers mutual collaboration; data privacy, security, and ownership; compliance with current regulations; scalability and modularity; and the scope of interoperability and standards. Conclusions: We propose to join forces to pave the way to the interoperable Internet and audiology products, features, and services that the world needs.

  • 17.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Brannstrom, Jonas K.
    Lund University, Sweden.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Stages of Change in Adults Who Have Failed an Online Hearing Screening2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 1, 92-101 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. Design: In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. Results: A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. Conclusions: The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.

  • 18.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Brännström, K Jonas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Quality and readability of English-language internet information for adults with hearing impairment and their significant others2012In: International Journal of Audiology, ISSN 1499-2027, Vol. 51, no 8, 618-626 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This study evaluated the quality and readability of English-language internet information for adults with hearing impairment and their significant others. Design: Two keyword pairs (hearing loss and hearing aids) were entered into five country-specific versions of the most commonly used internet search engine in May 2011. Sample: For each of the 10 searches, the first 10 relevant websites were included. After removing duplicates, a total of 66 websites were assessed. Their origin (commercial, non-profit organization, or government), date of last update, quality (Health On the Net (HON) certification and DISCERN scores), and readability (Flesch Reading Ease Score, Flesch-Kincaid Grade Level Formula, and Simple Measure Of Gobbledygook) were assessed. Results: Most websites were of commercial origin and had been updated within the last 18 months. Their quality and readability was highly variable. Only 14% of the websites had HON certification. Websites that were of non-profit organization origin had significantly higher DISCERN scores. Readability measures show that on average, only people with at least 11-12 years of education could read and understand the internet information presented. Conclusions: Based on these results, this article provides a list of recommendations for website developers and clinicians wishing to incorporate internet information into their practice.

  • 19.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Dons Jensen, Lisbeth
    Eriksholm Research Centre, Denmark .
    Dawes, Piers
    University of Manchester, England .
    Nielsen, Claus
    Eriksholm Research Centre, Denmark .
    Optimal Hearing Aid Use: Focus Groups With Hearing Aid Clients and Audiologists2013In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 34, no 2, 193-202 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: This study explored the meaning and determinants of optimal hearing aid use from the perspectives of hearing aid clients and audiologists. An additional objective was to contrast the perspectives of the clients and audiologists. less thanbrgreater than less thanbrgreater thanDesign: Four focus groups were conducted: (1) clients (n = 7) in Denmark, (2) clients (n = 10) in the United Kingdom, (3) audiologists (n = 6) in Denmark, and (4) audiologists (n = 7) in the United Kingdom. Clients owned hearing aids and audiologists had regular contact with clients. The focus group facilitators used a topic guide to generate the participants views on optimal hearing aid use. The focus groups were audio-recorded, transcribed verbatim, translated into English if conducted in Danish, and qualitatively analyzed with content analysis. less thanbrgreater than less thanbrgreater thanResults: Both clients and audiologists described optimal hearing aid use as being frequent and regular and driven by the individual needs of the clients. When describing determinants of optimal hearing aid use, both clients and audiologists mentioned the role of the client (e. g., adjustment to hearing aids), the role of the audiologist (e. g., audiologic practice and profession), and the role of the hearing aid (e. g., benefits and limitations of the hearing aid). They both highlighted the importance of client access to information. However, how clients and audiologists described the influence of these determinants varied somewhat. Clients emphasized the role of the hearing aid in achieving optimal hearing aid use. From a client perspective, hearing aids that performed well and had relevant features were most central. In contrast, audiologists emphasized the role of a good client-audiologist relationship in achieving optimal hearing aid use. From the audiologists perspective, audiologists who were able to understand the needs of the clients and to instruct clients appropriately were most central. less thanbrgreater than less thanbrgreater thanConclusions: This study highlights similarities and differences in how clients and audiologists describe optimal hearing aid use and its determinants. It is commendable that audiologists acknowledge the importance of the client-audiologist relationship, but given clients focus on hearing aids, audiologists might wish to describe more explicitly to their clients how their intervention can extend beyond provision of the optimal hearing aid. (Ear andamp; Hearing 2013;34;193-202)

  • 20.
    Laplante-Lévesque, Ariane
    et al.
    Eriksholm Research Centre, Snekkersten, Denmark.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Victoria, Australia.
    Grenness, Caitlin
    HEARing Cooperative Research Centre, Melbourne, Victoria, Australia.
    An Australian survey of audiologists’ preferences for patient-centredness2014In: International Journal of Audiology, ISSN 1499-2027, Vol. 53, no S1, S76-S82 p.Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centredness is becoming a core value of health services worldwide, however it remains largely unexplored in audiology. This study investigated audiologists’ preferences for patient-centredness and identified factors that explain audiologists’ preferences for patient-centredness. Design: All members of the Audiological Society of Australia received two questionnaires: (1) a descriptive questionnaire (e.g. age, gender, place of residence, years in practice, employment characteristics), and (2) a modified patient-practitioner orientation scale (PPOS; Krupat et al, 2000) which measures preferences for two aspects of patient-centredness, sharing and caring. Study sample: In total 663 (46%) audiologists returned both questionnaires fully completed. Results: Mean PPOS scores indicated that audiologists prefer patient-centredness. Linear regression modelling identified that older audiologists, that had practiced longer, and who worked in community education, industrial audiology, or teaching had a signifi cantly greater preference for patient-centredness than their peers. In contrast, audiologists who practiced in a private environment and who worked in the area of assessment of adults had a significantly lesser preference for patient-centredness than their peers. Conclusions: Audiologists prefer client-centredness and age, years of experience, and employment characteristics can partly explain preferences for patient-centredness. Future research should explore the relationships between patient-centredness and intervention outcomes in audiology.

  • 21.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Australia .
    Hickson, Louise
    University of Queensland, Australia.
    Worrall, Linda
    University of Queensland, Australia.
    A qualitative study of shared decision making in rehabilitation audiology2010In: Journal of the Academy of Rehabilitative Audiology, ISSN 0149-8886, Vol. 43, 27-43 p.Article in journal (Refereed)
    Abstract [en]

    This study examined rehabilitative audiology clients’ experiences with shared decision making. Adults with acquired hearing impairment and with no previous experience of rehabilitative audiology were recruited for a shared decision making clinical trial. A sample of 22 participants completed an in-depth interview which was transcribed and analyzed using content analysis. The results were organized into an evidence-based model of rehabilitative audiology shared decision making. Participants described decision making by its actors, processes, and dimensions. Two themes, “my story” and “trust,” highlight the importance of a client-centered and ethical approach to shared decision making in rehabilitative audiology.

  • 22.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia and Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    Comparing response options for the International Outcome Inventory for Hearing Aids (IOI-HA) and for Alternative Interventions (IOI-AI) daily-use items2012In: International Journal of Audiology, ISSN 1499-2027, Vol. 51, no 10, 788-791 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    This study investigated how clients quantify use of hearing rehabilitation. Comparisons focused on the daily-use item of the International Outcome Inventory for Hearing Aids (IOI-HA), and for Alternative Interventions (IOI-AI).

    DESIGN:

    Adults with hearing impairment completed the original versions of the IOI-HA and the IOI-AI daily-use item which has five numerical response options (e.g. 1-4 hours/day) and a modified version with five word response options (e.g. 'Sometimes'). Respondents completed both IOI versions immediately after intervention completion and three months later.

    STUDY SAMPLE:

    In total, 64 people who had obtained hearing aids completed both IOI-HA versions and 27 people who had participated in communication programs completed both IOI-AI versions.

    RESULTS:

    Participants reported higher scores on the modified (word) daily-use item than on the original (number) daily-use item. Participants who completed the IOI-AI did so significantly more than participants who completed the IOI-HA. This was true both after intervention completion and three months later.

    CONCLUSION:

    This study showed that comparisons between IOI-HA and IOI-AI daily-use item scores should be made with caution. Word daily-use response options are recommended for the IOI-AI (i.e. Never; Rarely; Sometimes; Often; and Almost always).

  • 23.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    Factors influencing rehabilitation decisions of adults with acquired hearing impairment2010In: International Journal of Audiology, ISSN 1499-2027, Vol. 49, no 7, 497-507 p.Article in journal (Refereed)
    Abstract [en]

    Several rehabilitation interventions yielding comparable outcomes are available to adults with acquired hearing impairment. However, the reasons why people choose particular interventions and not others have not been systematically investigated. This study explored the factors influencing the rehabilitation decisions of adults with acquired hearing impairment. Four options (hearing aids, group communication program, individual communication program, and no intervention) were discussed using shared decision making with 153 adults with acquired hearing impairment who had not previously received hearing rehabilitation. A selected sub-sample of 22 participants described the factors that influenced their decision during a semi-structured interview. Using qualitative content analysis, seven categories of factors influencing rehabilitation decisions were identified: (1) convenience; (2) expected adherence and outcomes; (3) financial costs; (4) hearing disability; (5) nature of intervention; (6) other people’s experiences, recommendations, and support; and (7) preventive and interim solution. All categories of factors were a positive influence for a particular intervention for some participants and a negative influence for the same intervention for other participants. The results support a client-centred approach to decision making.

  • 24.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia and Eriksholm Research Centre, Oticon, Snekkersten, Denmark.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    Matching evidence with client preferences2012In: Evidence-based practice in audiology: evaluating interventions for children and adults with hearing impairment / [ed] Lena Wong and Louise Hickson, San Diego, CA: Plural Publishing, Inc., 2012, 41-58 p.Chapter in book (Other academic)
  • 25.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    Predictors of Rehabilitation Intervention Decisions in Adults With Acquired Hearing Impairment2011In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 54, 1385-1399 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: This study investigated the predictors of rehabilitation intervention decisions in middle-age and older adults with acquired hearing impairment seeking help for the first time.

    Method: Using shared decision making, 139 participants were offered intervention options: hearing aids, communication programs (group or individual), and no intervention. Multivariate analysis (logistic regression) provided odds ratios and 95% confidence intervals for intervention decision predictors when all other variables were held constant.

    Results: Seven intervention decision predictors were identified: (a) application for subsidized hearing services (participants more likely to choose hearing aids and less likely to choose communication programs), (b) hearing impairment (hearing aids more likely and no intervention less likely), (c) communication self-efficacy (hearing aids less likely), (d) powerful others as locus of control (hearing aids less likely), (e) hearing disability perceived by others and self (hearing aids more likely), (f ) perceived communication program effectiveness (communication programs more likely), and (g) perceived suitability of individual communication program (hearing aids less likely and communication programs more likely).

    Conclusion: Findings suggest the need for clinicians to explicitly elicit the predictors identified by this study when involving adults with acquired hearing impairment in intervention decisions.

  • 26.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    Rehabilitation of older adults with hearing impairment: A critical review2010In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 22, no 2, 143-153 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: Hearing impairment, which affects both peripheral and central structures of the auditory system, is highly prevalent among older adults and has serious consequences both for the people with hearing impairment and for those around them. This article provides an updated overview of the rehabilitation of this population.

    Methods: This article critically reviews the rehabilitation interventions available to older adults with hearing impairment: hearing aids, hearing assistance technology, and communication programs.

    Results: Current evidence suggests positive outcomes of similar magnitude for the three rehabilitation interventions, however their availability/uptake and adherence are suboptimal.

    Discussion: To improve the current situation, two changes to practice are warranted. First, availability of the range of rehabilitation interventions should be improved. Second, in accordance with the self-management of other chronic health conditions, older adults with hearing impairment should be invited to be actively involved in their rehabilitation.

  • 27.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Australia and Eriksholm Research Centre, Oticon, Denmark.
    Hickson, Louise
    University of Queensland, Australia.
    Worrall, Linda
    University of Queensland, Australia.
    Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation2013In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 34, no 4, 447-457 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    This study investigated the application of the transtheoretical (stages-of-change) model in audiologic rehabilitation. More specifically, it described the University of Rhode Island Change Assessment (URICA) scores of adults with acquired hearing impairment. It reported the psychometric properties (construct, concurrent, and predictive validity) of the stages-of-change model in this population.

    DESIGN:

    At baseline, 153 adults with acquired hearing impairment seeking help for the first time completed the URICA as well as measures of degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Participants were subsequently offered intervention options: hearing aids, communication programs, and no intervention. Their intervention uptake and adherence were assessed 6 months later and their intervention outcomes were assessed 3 months after intervention completion. First, the stages-of-change construct validity was evaluated by investigating the URICA factor structure (principal component analysis), internal consistency, and correlations between stage scores. The URICA scores were reported in terms of the scores for each stage of change, composite scores, stages with highest scores, and stage clusters (cluster analysis). Second, the concurrent validity was assessed by examining associations between stages of change and degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Third, the predictive validity was evaluated by investigating associations between stages of change and intervention uptake, adherence, and outcomes.

    RESULTS:

    First, in terms of construct validity, the principal component analysis identified four instead of three stages (precontemplation, contemplation, preparation, and action) for which the internal consistency was good. Most of the sample was in the action stage. Correlations between stage scores supported the model. Cluster analysis identified four stages-of-change clusters, which the authors named active change, initiation, disengagement, and ambivalence. In terms of concurrent validity, participants who reported a more advanced stage of change had a more severe hearing impairment, reported greater hearing disability, and had a hearing impairment for a longer period of time. In terms of predictive validity, participants who reported a more advanced stage of change were more likely to take up an intervention and to report successful intervention outcomes. However, stages of change did not predict intervention adherence.

    CONCLUSIONS:

    The majority of the sample was in the action stage. The construct, concurrent, and predictive validity of the stages-of-change model were good. The stages-of-change model has some validity in the rehabilitation of adults with hearing impairment. The data support that change might be better represented on a continuum rather than by movement from one step to the next. Of all the measures, the precontemplation stage score had the best concurrent and predictive validity. Therefore, further research should focus on addressing the precontemplation stage with a measure suitable for clinical use.

  • 28.
    Laplante-Lévesque, Ariane
    et al.
    University of Queensland, Brisbane, Australia and Eriksholm Research Centre, Oticon, Snekkersten, Denmark.
    Hickson, Louise
    University of Queensland, Brisbane, Australia.
    Worrall, Linda
    University of Queensland, Brisbane, Australia.
    What makes adults with hearing impairment take up hearing AIDS or communication programs and achieve successful outcomes?2012In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 33, no 1, 79-93 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Client involvement in health decision making, or shared decision making, is increasingly being advocated. For example, rehabilitation interventions such as hearing aids and communication programs can be presented as options to adults with hearing impairment seeking help for the first time. Our previous research focused on the predictors of intervention decisions when options were presented with a decision aid. However, not all participants took up the intervention they initially decided upon. Although it is interesting to understand what informs adults with hearing impairment's intervention decisions, it is their intervention uptake and outcomes which best represent the ultimate end result of the rehabilitation process. This prospective study investigated the predictors of uptake and of successful outcomes of hearing aids and communication programs in middle-aged and older adults with hearing impairment seeking help for the first time.

    DESIGN:

    Using shared decision making, 153 participants with hearing impairment (average of air conduction thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB HL in at least one ear) aged 50 yr and older were presented with intervention options: hearing aids, communication programs (group or individual), and no intervention. Each participant received a decision aid and had at least 1 wk to consider intervention options before the intervention decision was made. Outcome measures for both hearing aids and communication programs at 3 mo after intervention completion were benefit (measured with the Client-Oriented Scale of Improvement), composite outcomes (measured with the International Outcome Inventory), and reduction in self-reported hearing disability (measured with the Hearing Handicap Questionnaire). Multivariate analysis (logistic and linear regression) identified predictors of intervention uptake and of successful outcomes when all other variables were held constant.

    RESULTS:

    Almost a quarter of the 153 participants (24%) did not take up the intervention they initially decided upon: 6 mo after making their intervention decision, 66 participants (43%) obtained hearing aids, 28 participants (18%) completed communication programs, and 59 participants (39%) did not complete an intervention. Seven intervention uptake predictors were identified: (1) application for subsidized hearing services (participants more likely to obtain hearing aids and less likely to complete no intervention); (2) higher socioeconomic status (no intervention less likely); (3) greater communication self-efficacy (hearing aids less likely); (4) greater contemplation stage of change (no intervention less likely); (5) greater hearing disability perceived by others and self (communication programs less likely); (6) greater perceived communication program effectiveness (communication programs more likely); and (7) greater perceived suitability of individual communication program (hearing aids less likely and communication programs more likely). Six predictors of successful intervention outcomes were identified: (1) higher socioeconomic status; (2) greater initial self-reported hearing disability; (3) lower precontemplation stage of change; (4) greater action stage of change; (5) lower chance locus of control; and (6) greater hearing disability perceived by others and self.

    CONCLUSIONS:

    Self-reported hearing disability and stages of change are the two most robust predictors of intervention uptake and successful outcomes. Clinicians should offer intervention options and should discuss these predictors when helping adults with hearing impairment make optimal decisions.

  • 29.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Preminger, Jill E.
    University of Louisville, KY 40292 USA.
    Internet and Audiology: A Review of the Second International Meeting2016In: AMERICAN JOURNAL OF AUDIOLOGY, ISSN 1059-0889, Vol. 25, no 3, 257-259 p.Article, review/survey (Refereed)
    Abstract [en]

    Purpose: This article describes the Second International Meeting on Internet and Audiology, which took place at the Eriksholm Research Centre, Oticon A/S, Denmark September 24 to 25, 2015, and introduces the research forum arising from the meeting. Method: The potential gains of the Internet within audiology are framed within the central role of quality connections among people, ideas, and objects. First, the meeting is summarized. Second, the 11 articles arising from the meeting and collected in this research forum are grouped into 2 themes: design and evaluation. Last, the benefits of interoperability and standardization are discussed. Conclusion: We look forward to the day when the Internet is an integral part of audiology, and we invite readers to attend future editions of the International Meeting on Internet and Audiology.

  • 30.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nielsen, Claus
    Oticon AS, Denmark .
    Dons Jensen, Lisbeth
    Oticon AS, Denmark .
    Naylor, Graham
    Oticon AS, Denmark .
    Patterns of Hearing Aid Usage Predict Hearing Aid Use Amount (Data Logged and Self-Reported) and Overreport2014In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 25, no 2, 187-198 p.Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies found that, on average, users overreport their daily amount of hearing aid use compared to objective measures such as data logging. However, the reasons for this are unclear. Purpose: This study assessed data-logged and self-reported amount of hearing aid use in a clinical sample of hearing aid users. It identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport. Research Design: This observational study recruited adult hearing aid users from 22 private dispensers in the Netherlands and in Denmark. Study Sample: The sample consisted of 228 hearing aid users. Typical participants were over the age of 65 and retired, were fitted binaurally, and had financially contributed to the cost of their hearing aids. Participants had on average a mild-to-severe sloping bilateral hearing impairment. Data Collection and Analysis: Participants completed a purposefully designed questionnaire regarding hearing aid usage and the International Outcome Inventory Hearing Aids. Dispensers collected audiometric results and data logging. Multiple linear regression identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport when controlling for covariates. Results: Data logging showed on average 10.5 hr of hearing aid use (n = 184), while participants reported on average 11.8 hr of daily hearing aid use (n = 206). In participants for which both data-logged and self-reported hearing-aid use data were available (n = 166), the average absolute overreport of daily hearing aid use was 1.2 (1 hr and 11 min). Relative overreport was expressed as a rate of absolute overreport divided by data-logged hearing aid use. A positive rate denotes hearing aid use overreport: the average overreport rate was .38. Cluster analysis identified two data-logged patterns: "Regular," where hearing aids are typically switched on for between 12 and 20 hr before their user powers them off (57% of the sample), and "On-off," where hearing aids are typically switched on for shorter periods of time before being powered off (43% of the sample). In terms of self-report, 77% of the sample described their hearing aid use to be the same every day, while 23% of the sample described their hearing aid use to be different from day to day. Participants for whom data logging showed an On-off pattern or who reported their hearing aid use to be different from day to day had significantly fewer data-logged and self-reported hours of Hearing aid use. Having an On-off data-logging pattern or describing hearing aid use as the same every day was associated with a significantly greater hearing aid use overreport. Conclusions: Data-logged and self-reported usage patterns significantly predicted data-logged hearing aid use, self-reported hearing aid use, and overreport when controlling for covariates. The results point to patterns of hearing aid usage as being at least as important a concept as amount of hearing aid use. Dispensers should discuss not only the "how much", but also the "how" of hearing aid usage with their clients.

  • 31.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Denmark.
    Sundewall Thoren, Elisabet
    Eriksholm Research Centre, Denmark.
    Readability of Internet Information on Hearing: Systematic Literature Review2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, 284-288 p.Article, review/survey (Refereed)
    Abstract [en]

    Purpose: This systematic literature review asks the following question: "What is the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care?" Method: Searches were completed in three databases: CINAHL, PubMed, and Scopus. Seventy-eight records were identified and systematically screened for eligibility: 8 records were included that contained data on the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care. Results: Records reported mean readability levels from 9 to over 14. In other words, people with hearing impairment and their significant others need 9 to 14 years of education to read and understand Internet information on hearing that they access in the context of their hearing care. Conclusion: The poor readability of Internet information on hearing has been well documented; it is time to focus on valid and sustainable initiatives that address this problem.

  • 32.
    O’Halloran, Robyn
    et al.
    University of Queensland, Bundoora, Australia.
    Hersh, Deborah
    University of Queensland, Bundoora, Australia.
    Laplante-Lévesque, Ariane
    University of Queensland, Bundoora, Australia.
    Worrall, Linda
    University of Queensland, Bundoora, Australia.
    Person-Centeredness, Ethics, and Stories of Risk2010In: Seminars in Speech and Language, ISSN 0734-0478, Vol. 31, no 2, 81-89 p.Article in journal (Refereed)
    Abstract [en]

    Storytelling can be a powerful way to reflect on the ethical issues that emerge in clinical practice. This article uses two stories by speech-language pathologists to explore how notions of person-centered practice may influence speech-language pathology practice. Then these stories are examined in relation to definitions of personcentered practice and speech pathology code of ethics to discuss the ethical issues, challenges, and risks that these stories raise. Moving toward more person-centered ways of practicing will require speech-language pathologists to be open to the real lives of their clients with communication and swallowing disabilities. It may also require speech-language pathologists to be open to their own vulnerabilities as well.

  • 33.
    Preminger, Jill E.
    et al.
    University of Louisville, Kentucky, USA.
    Laplante-Lévesque, Ariane
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Perceptions of age and brain in relation to hearing help seeking and rehabilitation2014In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 35, no 1, 19-29 p.Article in journal (Refereed)
    Abstract [en]

    Objectives:

    This study used a qualitative approach to explore the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Two superordinate themes, Age and Brain, emerged from prior analyses and are investigated in the present article.

    Design:

    In-depth semistructured interviews were completed in four countries with 34 adults (aged 26 to 96 years) with hearing impairment. Participants were asked to “Tell the story of your hearing.” Participants included individuals with different levels of experiences in hearing help-seeking and rehabilitation. The themes of Age and Brain emerged from the data based on qualitative content analysis. These major themes were analyzed further using interpretative phenomenology to create models of themes and subthemes as they related to hearing help-seeking and rehabilitation expectations and experience.

    Results:

    Age was discussed by 68% of the 34 participants. The data were sorted into three themes: Expectations, Self-Image, and Ways of Coping. Brain was discussed by 50% of the participants. The data were sorted into three themes: Cognitive Operations, Plasticity, and Mental Effort.

    Conclusions:

    Adults with hearing impairment think of their age and their brain as contributing to their hearing impairment, disability, help-seeking, and rehabilitation. Although hearing impairment associated with older age was typically construed as a stigma, not all perceptions of aging and hearing impairment were negative. Some participants viewed older age and its influence on relationships or priorities as a reason for seeking out hearing health care or as the determining factor in deciding to wear hearing aids (HAs). Some expected hearing impairment with older age, thus they found it easier to accept wearing HAs than they may have at a younger age. They discussed the brain in terms of the cognitive operations that may either inhibit or improve speech communication. Participants believed that they could train their brains to improve their communication (and sometimes avoid the need for HAs) or to increase their HA benefit. Age and Brain interconnected in a number of ways. Participants believed that older age led to cognitive decline, which resulted in decreased speech understanding. Participants also believed that the cognitive decline that accompanies older age may limit HA benefit. Hearing healthcare providers may wish to clarify negative messages about age and brain with their patients and provide information about how older brains are capable of changing and benefiting from HA use and comprehensive audiologic rehabilitation programs.

  • 34.
    Preminger, Jill E.
    et al.
    University of Louisville, KY 40292 USA.
    Oxenboll, Maria
    Oticon AS, Denmark.
    Barnett, Margaret B.
    University of Louisville, KY 40292 USA.
    Jensen, Lisbeth D.
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 1, 20-28 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This paper describes how trust is promoted in adults with hearing impairment within the context of hearing healthcare (HHC) service delivery. Design: Data were analysed from a previously published descriptive qualitative study that explored perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Study sample: Interview transcripts from 29 adults from four countries with different levels of hearing impairment and different experience with the HHC system were analysed thematically. Results: Patients enter into the HHC system with service expectations resulting in a preconceived level of trust that can vary from low to high. Relational competence, technical competence, commercialized approach, and clinical environment (relevant to both the clinician and the clinic) influence a patients resulting level of trust. Conclusions: Trust is evolving rather than static in HHC: Both clinicians and clinics can promote trust. The characteristics of HHC that engender trust are: practicing good communication, supporting shared decision making, displaying technical competence, offering comprehensive hearing rehabilitation, promoting self-management, avoiding a focus on hearing-aid sales, and offering a professional clinic setting.

  • 35.
    Pryce, Helen
    et al.
    Aston University, England.
    Hall, Amanda
    St Michaels Hospital, England.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Denmark.
    Clark, Elizabeth
    St Martins Hospital, England.
    A qualitative investigation of decision making during help-seeking for adult hearing loss2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 11, 658-665 p.Article in journal (Refereed)
    Abstract [en]

    Objective: The Any Qualified Provider framework in the National Health Service has changed the way adult audiology services are offered in England. Under the new rules, patients are being offered a choice in geographical location and audiology provider. This study aimed to explore how choices in treatment are presented and to identify what information patients need when they are seeking help with hearing loss. Design: This study adopted qualitative methods of ethnographic observations and focus group interviews to identify information needed prior to, and during, help-seeking. Observational data and focus group data were analysed using the constant comparison method of grounded theory. Study sample: Participants were recruited from a community Health and Social Care Trust in the west of England. This service incorporates both an Audiology and a Hearing Therapy service. Twenty seven participants were involved in focus groups or interviews. Results: Participants receive little information beyond the detail of hearing aids. Participants report little information that was not directly related to uptake of hearing aids. Conclusions: Participant preferences were not explored and limited information resulted in decisions that were clinician-led. The gaps in information reflect previous data on clinician communication and highlight the need for consistent information on a range of interventions to manage hearing loss.

  • 36.
    Saunders, Gabrielle H.
    et al.
    Portland VA Medical Centre, OR USA; Oregon Health and Science University, OR 97201 USA.
    Frederick, Melissa T.
    Portland VA Medical Centre, OR USA.
    Silverman, ShienPei C.
    Portland VA Medical Centre, OR USA.
    Nielsen, Claus
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Description of Adults Seeking Hearing Help for the First Time According to Two Health Behavior Change Approaches: Transtheoretical Model (Stages of Change) and Health Belief Model2016In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 37, no 3, 324-333 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: Several models of health behavior change are commonly used in health psychology. This study applied the constructs delineated by two models-the transtheoretical model (in which readiness for health behavior change can be described with the stages of precontemplation, contemplation and action) and the health belief model (in which susceptibility, severity, benefits, barriers, self-efficacy, and cues to action are thought to determine likelihood of health behavior change)-to adults seeking hearing help for the first time. Design: One hundred eighty-two participants (mean age: 69.5 years) were recruited following an initial hearing assessment by an audiologist. Participants mean four-frequency pure-tone average was 35.4 dB HL, with 25.8% having no hearing impairment, 50.5% having a slight impairment, and 23.1% having a moderate or severe impairment using the World Health Organization definition of hearing loss. Participants hearing-related attitudes and beliefs toward hearing health behaviors were examined using the University of Rhode Island Change Assessment (URICA) and the health beliefs questionnaire (HBQ), which assess the constructs of the transtheoretical model and the health belief model, respectively. Participants also provided demographic information, and completed the hearing handicap inventory (HHI) to assess participation restrictions, and the psychosocial impact of hearing loss (PIHL) to assess the extent to which hearing impacts competence, self-esteem, and adaptability. Results: Degree of hearing impairment was associated with participation restrictions, perceived competence, self-esteem and adaptability, and attitudes and beliefs measured by the URICA and the HBQ. As degree of impairment increased, participation restrictions measured by the HHI, and impacts of hearing loss, as measured by the PIHL, increased. The majority of first-time help seekers in this study were in the action stage of change. Furthermore, relative to individuals with less hearing impairment, individuals with more hearing impairment were at more advanced stages of change as measured by the URICA (i.e., higher contemplation and action scores relative to their precontemplation score), and they perceived fewer barriers and more susceptibility, severity, benefits and cues to action as measured by the HBQ. Multiple regression analyses showed participation restrictions (HHI scores) to be a highly significant predictor of stages of change explaining 30% to 37% of the variance, as were duration of hearing difficulty, and perceived benefits, severity, self-efficacy and cues to action assessed by the HBQ. Conclusions: The main predictors of stages of change in first-time help seekers were reported participation restrictions and duration of hearing difficulty, with constructs from the health belief model also explaining some of the variance in stages of change scores. The transtheoretical model and the health belief model are valuable for understanding hearing health behaviors and can be applied when developing interventions to promote help seeking.

  • 37.
    Saunders, Gabrielle H.
    et al.
    Portland VA Medical Centre, ME USA; Oregon Health and Science University, OR 97201 USA.
    Frederick, Melissa T.
    Portland VA Medical Centre, ME USA.
    Silverman, ShienPei C.
    Portland VA Medical Centre, ME USA.
    Nielsen, Claus
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Portland VA Medical Centre, ME USA.
    Health behavior theories as predictors of hearing-aid uptake and outcomes2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, S59-S68 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To understand hearing behaviors of adults seeking help for the first time through the application of two models of health behavior change: the transtheoretical model and the health belief model. Design: The relationships between attitudes and beliefs were examined relative to hearing-aid uptake and outcomes six months later. Study sample: One hundred and sixty adults completed the University of Rhode Island change assessment (targeting the transtheoretical model), and the hearing beliefs questionnaire (targeting the health belief model), as well as the hearing handicap inventory and the psychosocial impact of hearing loss scale, within two months of an initial hearing assessment. Six months later, participants completed these same questionnaires, while those who had taken up hearing aids also completed hearing-aid outcome questionnaires. Results: (1) Attitudes and beliefs were associated with future hearing-aid uptake, and were effective at modeling this behavior; (2) attitudes and beliefs changed following behavior change, and (3) attitudes and beliefs following behavior change were better predictors of hearing-aid outcomes than pre-behavior change attitudes and beliefs. Conclusion: A counseling-based intervention targeting the attitudes and beliefs assessed by the transtheoretical model and the health belief model has the potential to increase uptake of hearing health care.

  • 38.
    Weineland, Sandra
    et al.
    Linköping University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Oticon AS, Denmark.
    Carlbring, Per
    Stockholm University, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Peter
    Horselskadades Riksforbund, Sweden.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Bridging the Gap Between Hearing Screening and Successful Rehabilitation: Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, 302-306 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors-seeking health care and using hearing aids-would shed light on how to use the Internet to assist people with hearing impairment.

  • 39.
    Wilson, Wayne J
    et al.
    University of Queensland, Australia.
    Hill, Anne E
    University of Queensland, Australia.
    Hughes, Jane
    University of Queensland, Australia.
    Sher, Auriel
    University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    University of Queensland, Australia.
    Student Audiologists' Impressions of a Simulation Training Program2010In: Australian and New Zealand Journal of Audiology, ISSN 1443-4873, Vol. 32, no 1, 19-30 p.Article in journal (Refereed)
    Abstract [en]

    The use of standardised patients (SPs) and computer based simulations (CBSs) has been suggested as a method of providing students in the health sciences with basic clinical skills without relying on extensive support from external clinics. This study used a questionnaire to determine if 25 first-year audiology students from an audiology program in a large Australian university felt their interactions with SPs and CBSs had improved their ability to interact with clients and perform a basic audiometric assessment. These students reported their interactions with the SPs significantly (p < .01) improved their performance in 10 out of 10 areas of client interaction and their interactions with the CBS significantly (p < .01) improved their abilities in 6 out of 8 areas of basic audiometry. They also reported that the SPs’ portrayals of the cases and the content of the simulated cases were realistic, although further preparation for interacting with the SPs was desirable. Overall, these results support the continued investigation of SPs and CBSs as potential methods of training and assessing Australian audiology students in the areas of client interaction and basic audiometry.

  • 40.
    Wänström, Gunilla
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rydberg, Emelie
    Swedish Institute for Disability Research, School of Health and Medical Science, Linnaeus Centre HEAD, Örebro University.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    The psychological process from avoidance to acceptance in adults with acquired hearing impairment2014In: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 12, no 1, 27-35 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This study explored the psychological process from avoidance to acceptance in adults with acquired hearing impairment. Study design: A descriptive qualitative interview study was conducted in Sweden in 2010. Participants were 18 adults with an acquired sensorineural hearing impairment aged 50-70 years, who had recently obtained hearing aids at the Audiology Clinic of the Örebro University Hospital. The sample included both first-time hearing aid users (n = 10) and experienced hearing aid users (n = 8). Each participant took part in one semi-structured interview. Qualitative content analysis was performed on the manifest content of the interview transcripts. Results: Participants described the process from avoidance to acceptance as a slow and gradual process rooted in the awareness of the frequency and severity of hearing disability and of its psychological consequences. Facilitators included adaptive coping mechanisms, other peoples comments and positive experiences, accessibility of help-seeking and routine health assessments. In contrast, barriers included maladaptive coping mechanisms and stigma. Conclusions: Participants described the process of acceptance as a personal process that involved, to some extent, their social network of family, friends and colleagues. It was also a trade-off between the consequences of untreated hearing impairment and the threat to normal identity that, through stigma, hearing impairment carries. Further studies are needed to fully investigate the role of access to information on hearing impairment acceptance. How professionals and society can facilitate the process of acceptance should also be a focus of future research efforts. 

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